A Retrospective Analysis of Maternal and Child Outcomes Following an Obesity Intervention Program

Background: One of the highest risk groups for childhood obesity and associated co-morbidities in the United States are low-income Hispanic preschool children. To reduce obesity, effective interventions are being sought to improve health behaviors among high risks groups. Objectives: To evaluate a subset of data from a larger 9-month promotora facilitated obesity intervention study. The aims were to determine: 1) pre- to post-program differences in health behaviors including: (a) children\u27s consumption of high carbohydrate beverages (HCB); and (b) maternal walking, beliefs, knowledge, self-efficacy, and relationship building regarding nutrition and physical activity; and 2) which covariates were significant for change in outcome variables. Methods: A retrospective data analysis, pre post single group design was used to analyze a subset of data from the larger study consisting of a case sample of 33 low-income, Hispanic mothers (18- to 35-year-olds) with pre-school children (3- to 5-year-olds). Differences in outcome variables for related samples between baseline and 9 months were examined using: descriptive statistics, a matched-pairs t-test, the Wilcoxon signed-ranks test, and the chi-square test. Pearson and Spearman correlations were performed to assess relationships between covariates and outcome variables, and if regression analysis assumptions were met. A backward step-wise linear regression was run to determine covariates significant for change in health behaviors. Results: From baseline to 9 months, there was a 56% decrease in children\u27s overall HCB consumption (soda, 100% juice, and sugary drinks); a 47% increase in water consumption; and a 58% increase in total maternal steps (Tuesday and Saturday). By 9 months, maternal beliefs were more positive about walking, knowledge increased about healthy drinks, and maternal self-efficacy improved regarding role modeling healthy behaviors. Gravida was correlated with increased Saturday steps and increased water consumption; and promotora visits were correlated with increased consumption of soda. Implications: Findings suggest a 9-month childhood obesity intervention program was effective in improving the target health behaviors for a low-income Mexican American community and identifying effective means for reducing the incidence of obesity in high risks groups. A larger randomized control trial is needed to further test the feasibility of this intervention program

Cultural Adaptation for Ethnic Diversity: A Review of Obesity Interventions for Preschool Children

Obesity disproportionately affects U.S. ethnic minority preschool children, placing them at risk for obesity related co-morbidities and premature death. Effective culturally appropriate interventions are needed to improve health behaviors and reduce obesity in young high-risk minority children, while their behaviors are still developing. All known obesity intervention studies (e.g., diet and physical activity) since 2000 targeting U.S. ethnic minority preschool children were reviewed. Five electronic databases and eight published literature reviews were used to identify the studies. Intervention studies without identified ethnic minority participants were excluded. Ten obesity interventions studies met the review criteria. Published cultural adaptation guidelines were used to develop a mechanism to analyze, score, and rank the intervention adaptations. Cultural adaptations varied widely in rigor, depth, and breadth. Results indicated a relative absence of appropriately adapted obesity interventions for ethnic minority groups, suggesting a need for more rigorous cultural adaptation guidelines when designing obesity interventions for diverse ethnicities. Culturally appropriate adaptations appeared to enhance intervention relevance, effectiveness, and feasibility. The purpose of this literature review was to evaluate 1) the type and extent of cultural adaptations strategies applied to the interventions, and 2) how these adaptations related to the study outcomes

Volunteer Income Tax Assistance (VITA) Program Dramatically Increases Knowledge Retention And Student Skills

In academia, faculty have the challenge of developing programs that will instill in the students the core competencies and skills defined by the accounting profession as the benchmark for successful entry into the accounting profession by college graduates. By integrating participation in the Volunteer Income Tax Assistance program with the teaching of concepts in the classroom at Utah Valley State College, faculty have been able to increase the retention of knowledge and the development of practical skills that benefit students, potential employers, and the community

Correction: A Feasible and Efficacious Mobile-Phone Based Lifestyle Intervention for Filipino Americans with Type 2 Diabetes: Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/diabetes.8156.]

Using appropriate body mass index cut points for overweight and obesity among Asian Americans

Objective. Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Method. were applied for other groups. Results. Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p b 0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI = 23-24.9 kg/m 2 and Koreans, Filipinos and Japanese with BMI = 27.5-29.9 kg/m 2 , the ranges WHO recommends as overweight or obese for Asians but not for other groups. Conclusions. Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans

Gender Differences in Lay Knowledge of Type 2 Diabetes Symptoms Among Community-dwelling Caucasian, Latino, Filipino, and Korean Adults - DiLH Survey

PURPOSE: The purpose of this study was to explore gender differences in lay knowledge of type 2 diabetes symptoms among community-dwelling Caucasian, Latino, Filipino, and Korean Americans. DESIGN AND METHODS: A cross-sectional survey was administered to a convenience sample of 904 adults (172 Caucasians, 248 Latinos, 234 Koreans, and 250 Filipinos) without diabetes at community events, community clinics, churches, and online in the San Francisco Bay Area and San Diego from August to December 2013. Participants were asked to describe in their own words signs and/or symptoms of diabetes. A multiple logistic regression analysis was performed to examine the association of lay symptom knowledge with gender after controlling for potential confounding factors. RESULTS: Overall, the average age of the sample populations was 44 (SD ±16.1) years, 36% were male, and 58% were married. Increased thirst/dry mouth following increased urinary frequency/color/odor and increased fatigue/lethargy/low energy were the most frequently reported signs and symptoms (19.8%, 15.4%, and 13.6%, respectively). After controlling for known confounding factors, women were 1.6 (95% confidence interval, 1.2-2.3, P = .004) times more likely than men to report at least 1 diabetes symptom. However, this gender difference in knowledge of diabetes signs and symptoms did not significantly differ across Caucasians, Latinos, Filipinos, and Korean Americans (P = .87). CONCLUSION: The findings underscore the importance of improving public knowledge and awareness of signs and symptoms of diabetes, particularly in men

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival